Proposal form - Communities

Name

Full name

Organisation

Phone number

Email address

Postal Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code

If you are an organisation then please tell us more

How long have you been operating for?

What do you do?

Have you any prior experience in running this type of asset or community initiative?

Are you a

Registered charity

Industrial and provident society

Community interest company

Social enterprise

Other voluntary organisation - please describe

Details

Your interest

Select the community your are internested in

Which service review (if any) referred you to this form?

I am interested in talking to you about an asset or assets

Yes

No

(if yes, please specify which one):

Which asset

I am interested in talking to you about setting up a new community initiative

Yes

No

Please provide us with a brief outline of your proposal. Please include any information on how it (asset/community initiative) will be sustained:

Please briefly set out how your proposal will help to meet agreed local priorities or recognised needs:

Could you operate out of other local community facilities? If so, please specify:

What kind of support do you think you would need to start to turn your proposal into a reality?

Other supporting information

Please describe what wider community support you have for this proposal:

Have you discussed your proposal with any other local organisations? If so, please specify which ones and whether there is any potential to develop your proposal in partnership with them:

To help us facilitate a wider discussion in your community we would like your consent to share your submitted information with other interested parties and publish this on this website. This would be really in helping foster a fuller conversation in your community on the services and assets that it wants and needs. Thank you.

I consent to my details being shared with others for this purpose:

Yes

No

Please enter the characters shown in the box provided to confirm your submission:

Email

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